MEDICARE: RESIDENTIAL MEDICAL SUPPLY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	1232010	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689682866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESIDENTIAL MEDICAL SUPPLY SERVICES

Provider Business Mailing Address
First Line	:	7200 BANCROFT AVE
Second Line	:	SUITE 128
City	:	OAKLAND
State	:	CA
Zip	:	94605-2403
Country	:	US
Telephone Number	:	510-553-9159
Fax Number	:	510-553-9256

Provider Business Practice Location Address
First Line	:	7200 BANCROFT AVE
Second Line	:	SUITE 128
City	:	OAKLAND
State	:	CA
Zip	:	94605-2403
Country	:	US
Telephone Number	:	510-553-9159
Fax Number	:	510-553-9256

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CHARLES LEE KELLY SEABORN
Credential	:
Telephone Number	:	510-553-9159

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	08/22/2020

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Directions to “RESIDENTIAL MEDICAL SUPPLY SERVICES ” Practice Location

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